Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
May 27, 2026 · via Europe PMC
Frailty 1 year after liver transplant is associated with long-term mortality: From the Functional Assessment in Liver Transplantation (FrAILT) Study.
Wang M, Kappus MR, Shui AM, +8 more, Lai JC.
AI summary — for doctors, generated from the abstract only
Being frail one year after liver transplant roughly doubled later mortality and worsened physical quality of life, making that first year a key window for frailty assessment.
What was studied
Multicentre cohort (FrAILT) of 1,097 adults who had liver transplant in 2013-2023 and an ambulatory Liver Frailty Index assessment at about 12 months, followed for survival and SF-36 quality of life.
Key findings
- 144 of 1,097 recipients (13%) were frail at 1 year
- Mortality at 3, 5 and 7 years after assessment was 13%, 24%, 32% in frail vs 6%, 10%, 16% in non-frail
- Adjusted mortality risk 2.0 times higher with frailty (95% CI 1.2-3.4); physical quality of life was lower
- Those who went from not frail before transplant to frail at 1 year had 2.5-fold higher mortality
Clinical relevance
Post-transplant frailty is measurable and prognostic, so transplant hepatologists can use it to identify recipients who may benefit from rehabilitation or closer follow-up.
Who should care
Limitations
Observational design cannot show that treating frailty improves survival, and only recipients who had a 1-year assessment were included.
Assess frailty with the Liver Frailty Index around one year after transplant and target frail recipients for mitigation strategies.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Frailty before liver transplantation (LT) is a critical determinant of outcomes after LT. While frailty often improves after LT, it persists-and even worsens-in some. The extent to which post-LT frailty impacts longer-term outcomes has not been characterized. Adults with cirrhosis who underwent LT between 2013 and 2023 from 9 centers with an ambulatory frailty assessment [by Liver Frailty Index (LFI)] 12 months (±6 mo) post-LT were included. Kaplan-Meier methods were used to estimate post-LT survival beyond 1 year (1y) post-LT. Associations between 1y post-LT frailty and subsequent mortality were assessed using Cox regression. Linear regression was used to explore the association between 1y post-LT frailty and health-related quality of life (HrQoL) using the 36-Item Short Form Survey. Among 1097 LT recipients, 144 (13%) patients were frail 1y post-LT. Those who were frail 1y post-LT were more often women (47% vs. 33%), had MASLD (40% vs. 19%), diabetes (44% vs. 30%), stroke (3.5% vs. 0.6%), and pre-LT frailty (37% vs. 16%) (all p ≤0.001). At 3, 5, and 7 years after the 1y post-LT assessment, mortality was higher among those who were frail versus not frail 1y post-LT (13% vs. 6%, 24% vs. 10%, and 32% vs. 16%). After multivariate adjustment, 1y post-LT frailty was associated with a 2.0 times increased risk of post-LT mortality (95% CI 1.2-3.4, p =0.01) and worse physical HrQoL (estimate -9.99, 95% CI -12.5 to -7.5, p <0.001). Patients who were frail 1y after LT experienced >2-fold increased risk of long-term mortality and poorer physical HrQoL. Patients who transitioned from not frail pre-LT to frail 1y post-LT had a 2.5-fold increased risk of post-LT mortality (95% CI 1.3-4.8, p =0.005) compared with patients who remained not frail. These findings suggest the 1y period after LT may be a critical window for evaluating whether targeted frailty mitigation strategies may improve long-term survival among LT recipients.
DOI
10.1097/lvt.0000000000000910
PMID
42200628
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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